This is fatigue, the first of the four horsemen, and the one for which to watch continually, for in his train follow closely after in this order, disease, old age and death.

There is a normal fatigue, of course, for repetition of any muscular or mental act will in time bring fatigue that is normal, physiological, but that is completely relieved by rest.

This marks the difference between the fatigue of prolonged and severe exercise and that of acidosis, for the one is relieved by rest, while the other is not.

Why is one so tired after a full dinner? Surely if food is fuel then the average person has taken on a full load and should be full of pep and enthusiasm instead of so weary that the afternoon siesta is common even among some business men.

Digestion itself requires vitality, it diverts vitality from the task in hand, whatever this may be, to the new task of digestion, which accounts for the fact that one is sleepy and dull after an unusually hearty meal.

Athletes know better than to try to break any records on a full stomach, rather they wait till the stomach is well emptied before attempting anything unusual.

A member of the championship Pittsburgh Ball Club of 1909 told the writer that it was Fred Clark's invariable rule that no lunch was to be taken any day before the game except a bowl of soup and two slices of bread, as his old training experience told him that athletes get drowsy after a too full meal, and he did not like to lose games.

In the winter of 1924 the writer was taking a daily work-out with the business men's gymnasium class at the Central Y. M. C. A., Buffalo, together with a class largely professional, but almost wholly sedentary.

He had interested this group in the subject of fatigue from the standpoint of diet, through a short series of talks before the exercise began, and a class volunteered to make a test of diet on endurance.

In all, eighteen men were tested, those chiefly who were able to control dietary factors quite satisfactorily, as the married men who took not more than one meal downtown.

The army squat was selected as a fatigue check, and the men were promised fifty per cent increase in their endurance at the end of a month through simple separation of the incompatibles in their diet alone, that is, leaving the amount of the foods then eaten wholly aside from all consideration, they were instructed to separate from each other those foods that cannot digest together in the same stomach, as the starchy foods and the proteins.

Breakfast was wholly of fresh fruits, lunch was a starchy type of meal, and dinner a protein type.

Instead of fifty per cent they showed one hundred and sixty-five per cent increase in endurance, and all were cautioned and all promised not to use the squat except as a once a week check, as practice would of course increase endurance.

The heaviest man in the group carried sixty pounds excess and lost fifteen of this, while the lightest man in the group was fifteen pounds underweight and gained six, both on the same plan of diet.

It is always so, the thin building up and the fat reducing, all on the same diet, for after all it is merely normalising the intake of food.

Disease is the second of these four horsemen, and he waits hard by, for not long behind fatigue does he linger.

When we are tired the bars are down for everything, even a cold coming as the easiest infection after one gets too tired.

When we remember that all disease, all fatigue (except the normal physiological kind), all old age, and finally all death, are all from one thing, then we will begin to think seriously about the causes of this one thing, and will seek means to avoid it always in the future.

Adding together the statements before alluded to, that there is but one disease--deficient drainage, and the other, that all deaths from so-called natural causes are merely the end-point of a progressive acid saturation, then we have something very concrete on which to build a theory of disease.

Disease never comes out of a clear sky, suddenly, no matter how sudden its first manifestation, for the conditions that have made this sudden appearance possible have been long brewing.

The first appearance of the first of these four horsemen is the point at which to become interested in one's condition, for this is the very beginning of acid saturation, and high time already to do something to stop it.

"If the little leaks are all taken care of, the big ones will take care of themselves," as they say in Holland.

If all the causes of fatigue are removed then disease will take care of itself, for there will be no disease where there is not a preceding fatigue; in other words, the second horseman never precedes the first.

The second horseman comes to us in a variety of forms, for we surely are subject to a myriad of dissimilar affections, from corns to consumption, yet we can set it down in the book of things as they are that all these various things grow out of one similar soil.

Just as the earthy soil raises a great crop of variegated flora, even so does our body soil raise a widely variegated crop of diseases. Now just as surely as that we cannot get out of a thing more than is in that thing, just so surely can we get no disease growths out of a body that does not have in it the things on which this disease can grow and flourish.

The real disease then is not the symptoms that we recognize and list and catalog and tag with a name, for these are the outgrowth of the soil that must be present before such disease can appear, so the real disease is always and only the state of the soil that allows this thing to appear.

Sir William Arbuthnot Lane again with his one disease, deficient drainage, you see.

Also Dr. Crile's one cause of death. Seneca's suicide statement that man does not die, he kills himself.

The grain merchant had accumulated almost sufficient causes for death, the end-point, but he had just sufficient vitality left to get over the ridge, and he has been better ever since, because much of this acid soil was burned up and thrown off during this cataclysm that was labeled pneumonia.